MiCardis/Telmisartan

[ATorrez]

Hi Guys!

I kind of created an account here just for this purpose, so I can share my knowledge.

I used to have mild/moderate lipodystrophy and lipoatrophy. Well, back in 2004 when MiCardis was first approved my doctor put me on it for high blood pressure. I was amazed to find that after a year, without any change in medications, that my lipoatrophy/distrophy had improved a great deal. I could tell because I looked at photos of myself from back in 2004 and then again in early 2006.

It is currently being studied for this particular usage in both HIV- and HIV+ persons.

This is from clinicaltrials.gov and it's for HIV+ people out in California.

http://www.clinicaltrials.gov/ct2/show/NCT01088295?term=HIV&rcv_s=03%2F10%2F2010&rank=1

Now, it's just recently that they have started to study it in HIV+ people but there have been some small studies in HIV- people, where it has shown these positive effects.

Reduces Visceral Fat in Hypertensive Japanese Men:

http://www.ncbi.nlm.nih.gov/pubmed/18344626

http://www.ncbi.nlm.nih.gov/pubmed/17351377

Done in rats, but stil worth looking at:

http://hyper.ahajournals.org/cgi/content/full/47/5/1003


The medication in addition to being an angiotensin receptor blocker (ARB) is also a partial agonist of PPAR gamma. Now if you all remember correctly, there was recently a concluded clinical trial in which another PPAR gamma drug, Actos or Avandia, was shown to reverse lipoatrophy to an extent. The PPAR agonism of MiCardis is about 30% of that of Avandia and Actos, however, it is not associated with the weight gain and increase in cholestrol that the anti-deibetic drugs are.

This is already approved by the FDA as I pointed out earlier in my post. I have been taking it for almost 6 years and the only side effects I have derived from it have been positive. If you already have high blood pressure you can ask your doctor to change your medications or you can just ask to try it out for lipoatrophy/dystrophy, or you could always try to enroll in a clinical trial.

When I began taking the medication I was NOT taking a thymidine NRTI, I had switched to an NRTI sparing regiment due to the toxicities I was experiencing. If you remember rightly, Avandia and Actos showed mixed results in HIV+ people, but once the criteria for the studies excluded those taking thymidine analogues they saw a much more drastic effect.

Please don't flame me, I was just offering advice. I know what it can be like to live with the disorder and feel like there is no hope for treating it. It may or may not work for everyone, but it DID work for ME. I can't tell you if it will work for you, but I have seen an almost complete reversal, in 6 years, of the disorder.

[aztecan]

Hey ATorrez,

Thanks for posting this. It offers some glimmer of hope for some of us already living with the problems associated with lipodystrophy.

When you noticed your differences, was that recovery from lipoatrophy in the face or did it involve lipohypertrophy?

I have the latter and would like some non-surgical method to diminish it if possible. From what I have seen, surgery is expensive, painful and, often, the results are temporary.

Thanks again for the info.

HUGS,

Mark

[ATorrez]

Both. My problem was only mild to begin with. I had maybe a grade 2/3 facial atrophy and I had gained some weight around my midsection, whilst not gaining weight elsewhere. The effect has been progressive, though, it didn't happen all at once.

There was more of an effect around my midsection than there was with my face, the effect on my midsection was dramatic. I have gotten a PMMA treatment or two to correct any deficits, but I didn't have anything that anyone other than myself would have noticed.

[GSOgymrat]

I suspect taking this medication would be inadvisable if you are not hypertensive.

[ATorrez]

Well, it's been tested in both hypertensive and non-hypertensive patients and been shown to reduce organ fat.

And the clinical trials don't mention high blood pressure as an inclusion criteria, but IDK, maybe you know more than the people researching the medication.

[aztecan]

I suspect taking this medication would be inadvisable if you are not hypertensive.

It may be possible it would be an off-label use similar to the use of Lisinipril, which is also a medication for high blood pressure but, at reduced doses, is effective at helping to protect the kidneys.

I don't know if that is the case, but I can hope. I will be waiting to see what comes of these trials.

HUGS,

Mark

[ATorrez]

Well, 80 mg is the usual dose for those with hypertension, but there are other dosages available if the lower ones do the jobs. The one being studied is 40mg, not 80.

To be honest though, these drugs are not THAT powerful. My doctor said that most high blood pressure meds only lower the blood pressure about 6-8 mmHg, which is why so many people need more than one. I never noticed ANY side effects from the medication, other than the "positive" ones that I stated.

And like I said, they have tested it in non-hypertensive patients and found that it reduced organ fat.

[GSOgymrat]

I don't have any facts, just speculating. I wonder if I could participate in the clinical trial at UCLA.